Individual provider Active NPI

Kristin Kupka Webster, LCSW

  • Clinical Social Worker
  • San Diego, CA
National Provider Identifier
1902336837
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW16118 Issued in CA
Practice address
1250 6TH Ave Ste 100
San Diego, CA 92101-4368
Phone
(619) 269-4043
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW16118 CA Primary

Addresses

Primary practice location

1250 6TH Ave Ste 100
San Diego, CA 92101-4368

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541

Other identifiers 1

IdentifierTypeStateIssuer
LCSW16118OtherCACA BOARD OF BEHAVIORAL SCIENCES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117000893 CA Practitioner - Clinical Social Worker 8820322001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers of San Diego IncGroup PAC ID 3476446378, shared by 46 NPIs, 299 clinicians

Practice addresses (Care Compare)

1111 W Chase Ave
El Cajon, CA 92020-5710
Phone (619) 515-2499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW16118CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers of San Diego, Inc Current Accepting new patients
Family Health Centers of San Diego, Inc. CurrentSince Mar 7, 2019 Accepting new patients
Family Health Centers of San Diego, Inc CurrentSince Mar 7, 2019 Accepting new patients
Family Health Centers of San Diego Inc Current Accepting new patients
Family Health Centers of San Diego Inc CurrentSince Dec 10, 2023 Accepting new patients

Locations

1111 W Chase Ave
El Cajon, CA 92020
Phone (619) 515-2499

1000 Euclid Ave
National City, CA 91950
Phone (619) 267-8100

1250 6th Ave
Ste 100
San Diego, CA 92101
Phone (619) 515-2430

823 Gateway Center Way
San Diego, CA 92102
Phone (619) 515-2323

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1902336837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 6TH AVE STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921014368",
            "telephone_number": "619-269-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "KRISTIN",
        "middle_name": "KUPKA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW16118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "LCSW16118",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.